Nourishing Health Care Innovation: Vancouver Coastal Health’s Planetary Menus Pilot - A first in Canada

Nourish’s Anchor Cohort program is grounded in the critical role of collaboration in driving systemic change in health care. Below we tell the story of the transformative journey of Vancouver General Hospital’s development of the hospital-wide Planetary Health Menus project, a first in Canada.

At Nourish, we work with incredible innovators who drive positive change through their vision, initiative, and action. Nourish catalyzes the shift towards better food in health care by fostering collaboration and shared learning among innovators.

This work takes time because of the scope and scale of the change contemplated. But, when change is finally realized, it can feel like magic.

We felt the magic earlier this spring when Vancouver Coastal Health (VCH) launched its Planetary Health Menus pilot at the Vancouver General Hospital, the largest in B.C. The project was initiated by visionary champions who were supported by partners including Nourish through their participation in our second Cohort. Over two years in the Cohort, the VCH team bridged departmental silos, built support across the organization, and has now scaled their work from a prototype to a national success story.

The Critical Role of Relationships in Systems Change Work  

Relationships are the seeds from which change flourishes. This is one of the core tenets of Nourish’s Cohorts. For the past seven years, Nourish has been bringing together health care leaders to leverage their key roles within their organizations and communities to accelerate progress toward health for people and the planet. Our three cohorts to date have engaged over 30 health care organizations from coast to coast to coast, and one of the results from these longitudinal partnerships we are seeing today is the achievements of the VCH team. From the seeds nurtured by the cohort has come a watershed moment to elevate the national conversation around the pivotal role of plant-forward menus in health care climate action. 

Nourish’s Role: Bridging Silos to Cultivate Interdisciplinary Collaboration 

The VCH Planetary Health Menus Pilot was spearheaded by an interdisciplinary group of motivated changemakers who believe food is a lever for taking bold and ambitious climate action. The vision was brought to fruition by a cross-department partnership led by Dr. Annie LaLande, PhD Candidate and Surgical Resident at Vancouver General Hospital, and Tiffany Chiang, Director of Food Service Transformation and Strategic Projects at VCH. Together, they would bring the expertise of food service staff clinicians, dieticians, and planetary health experts with the work of Chef Ned Bell, a renowned sustainable food system expert.

In 2021, the team joined the second Nourish Anchor Cohort after it had completed its initial testing of planetary menus on a surgical ward. The Cohort program provided a collaborative space for the team to surface challenges, access resources, seek advice, and harness the benefits of collaborative learning within a community of cohort peers and alumni about what they could achieve together. It was within this nurturing ecosystem that the potential of food as a lever for change flourished. 

“We’ve long used the phrase ‘food is medicine’ and we’re finding that this is true not only for patients but for our planet as well. Providing tasty, nutritious meals, which is critical to recovery from illness and injury, also presents a significant opportunity to decrease our environmental footprint by focusing on lower-impact ingredients.”

— Dr. Annie Lalande

The VCH team built a truly cross-departmental team, building interest, participation, and commitment from the disciplines and departments required to realize their vision. With the right people on board, they learned they could go further faster, momentum grew, and the idea expanded from piloting on a ward to becoming a hospital-wide project. 

Nourish’s Food for Health Levers provides a framework on how food in health care can advance climate action, reduce health inequities, and promote community well-being and patient healing. In 2023, the VCH team in the Anchor Cohort conducted a successful six-month pilot to test and introduce flavourful and comforting meals for patients, made with fresh and nutritious ingredients to aid healing and recovery. The result demonstrated that hospital food can and should be delicious, nutritious, and an incredible opportunity to take climate action three times a day.

Together the VCH team dared to challenge the status quo, envisioning a future where hospital meals weren’t just sustenance, but a necessary ingredient in supporting planetary health. The Vancouver General Hospital pilot represents the first successful Canadian hospital-wide pilot of a plant-rich menu. Elaine Eppler, a VCH dietitian, described the pilot project as the most exciting endeavor in her 36-year career.

What’s Next: Sustaining Momentum and Scaling Impact

An in-depth analysis is underway to quantify the greenhouse gas emissions reductions during the project and to identify the menu changes with the greatest impact. Early predictions expect emissions to reduce by 15-20%. Patient satisfaction metrics are expected to soar, drastically reducing food waste and the associated costs. Beyond the project, the ripple effect is already expanding to reach other hospitals within the health authority and Nourish aims to build momentum with other hospitals making net zero commitments. 

Canadian Hospitals are Invited to Join the Movement for Planetary Health

Nourish invites Canadian health care organizations to seize the opportunity to leverage the power of food and join a growing global movement. For example, New York Public Hospitals, shifts to plant-based meals have already reduced emissions by 36% and Denmark’s action plan to transition to plant-based food offers grants and incentives to shift menus and develop value chains. There is a growing urgency for policy shifts to support this work, and hospitals are uniquely positioned to take a leadership role. Join a growing number of health care organizations committed to climate action through the Coolfood Pledge.

Nourish change in health care.  

Watch Nourish ambassador, Chef Ned Bell’s CTV interview on the project here.

Photo Credit: VCH

Opinion: Harnessing the healing power of food in Canadian health care

Vancouver Sun Op-Ed

Planetary Health Menu Pilot featuring Korean Gochujang Bowl by Chef Ned Bell - Credit Leila Kwok

Opinion: An estimated half of food served to patients goes uneaten. The Planetary Health Menu project at Vancouver General Hospital is testing the power of food with diverse and delicious menu items

Author of the article:

Dr. Annie Lalande, Ned Bell, Lana Brandt

Published Apr 10, 2024  •  Last updated 53 minutes ago  •  3 minute read

Canada is warming at more than twice the global rate and there is no shortage of headlines ringing the climate alarm louder than ever. The escalating environmental impacts from the climate emergency underscore the intricate interplay between human health and the well-being of our planet. As extreme temperatures become more common and air quality continues to be threatened by a fifth new season dedicated to forest fires, the toll on respiratory and cardiovascular health will continue to increase. And the risk of diseases transmitted to people from insects and animals and extreme weather events will impact human health and the infrastructure of health care. This burden unfortunately falls hardest on the most vulnerable members of our society, including our children, elders, those grappling with chronic health conditions, and individuals navigating the inequities of low socioeconomic status.

Responding to climate change mitigation and adaptation with bold courage is imperative for safeguarding planetary health and the future of generations to come. The health care sector has a tremendous opportunity to align with its core tenet of “do no harm” by taking bold climate leadership and addressing its current footprint.

A growing number of health care providers are realizing the under-utilized solution of food as medicine. Food powerfully intersects human and planetary health, making clear that nature and humans can only thrive together. The EAT-Lancet report identifies that our current food system operates beyond our planetary boundaries, and food is the single most powerful lever for returning to balance. Shifting away from intensively farmed meat and dairy to create menus where plant-based proteins and local, fresh ingredients take the spotlight will not only cut emissions but also improve patient healing.

Food in Canadian health care is a $4-billion annual opportunity to take significant climate action three times a day in health care food services and reduce food waste — an estimated half of food served to patients goes uneaten.

An innovative network of health care providers is leading in food-related solutions in Canada. As an organization dedicated to the transition toward more preventative, equitable, and sustainable health care systems, Nourish works with leaders through organizations like Vancouver Coastal Health, which has tested and proven the power of food with its Planetary Health Menu project at Vancouver General Hospital. Data is being gathered on patient experience and food waste and, over the coming months, the menu items that patients enjoyed the most will be incorporated into menus across VCH.

The project brought together food service leaders, dietitians, clinicians and sustainability experts to work alongside Ned Bell, renowned chef and sustainable food ambassador. Together, they created over two dozen diverse and delicious menu items that feature lower-impact and primarily plant-powered ingredients. The project also engaged local farmers and artisans to source fresh, local, and seasonal food where possible.

Health care providers have a timely opportunity to demonstrate leadership in planetary health. By transitioning to planetary health menus, institutions can leverage their significant buying power to improve healing, health equity, and climate action.

It is an opportunity to shift the way we think about hospital food to recognize the central role it plays in recovery from illness and injury, and to better nourish people. It is also a chance for health care organizations to not only model healthy and more sustainable eating patterns, but to provide inspiration for patients to maintain such practices at home, amplifying the lasting impact of such a change.

Canada was one of 124 countries that committed to the Climate and Health Declaration at the COP28 World Climate Action Summit. From tracking and reducing emissions data through the Coolfood Pledge to weaving Indigenous food ways into health care menus, concerted policy efforts can help address climate and health care challenges.

Health care has a timely opportunity — not to mention a moral imperative — to lead through daily action to address the climate emergency. By applying the power of food and shifting to sustainable and inclusive health care food service, together we can advance climate action, health equity, and community wellbeing. You can learn more about Planetary Health Menus at NourishLeadership.ca.

Dr. Annie Lalande is a surgical resident at Vancouver General Hospital; Ned Bell is a chef and sustainable food ambassador; Lana Brandt is strategic communications and engagement manager at Nourish.

Vancouver General Hospital pilots new plant-rich menu items for health of patients and planet

News Release: March 13, 2024

For the past six months, inpatients receiving care at Vancouver Coastal Health’s (VCH) Vancouver General Hospital have been able to fuel their healing with a diverse selection of new delicious, nutritious and environmentally sustainable menu items, thanks to a Planetary Health Menu Pilot project.

“Vancouver Coastal Health is committed to continually improving the patient experience and food is an important part of this,” said Darcia Pope, Vice-President, Strategy, Innovation and Planetary Health at Vancouver Coastal Health. “We started this project with the goal of creating flavourful, comforting meals using fresh, nutritionally dense ingredients so that patients had appealing food options to help them in their healing and recovery. We also recognized that this project presented an opportunity to look at how we could adjust our food services program to be more environmentally sustainable.”

The Planetary Health Menu Pilot project was led by Dr. Annie Lalande, surgical resident and PhD student in Resources, Environment and Sustainability at University of British Columbia (UBC), and Tiffany Chiang, Director, Food Service Transformation and Strategic Projects at VCH. They brought together food services staff, dietitians, clinicians and planetary health experts to work alongside Ned Bell, renowned chef and sustainable food champion, in developing the menu items.

More than 20 new menu items have been developed to offer patients a diversity of choices, incorporating patient preferences and ingredients with lower environmental impacts. These include dishes such as Steelhead Trout with Tomato Miso Dressing, Creamy Coconut Chickpea Curry with Cauliflower and Cashews, served with Mango Chutney and a Korean Gochujang Bowl. The new dishes were evaluated by patient partners who provided valuable feedback on the meal’s desirability during times of illness. Dishes that were favourably reviewed were served on a trial basis to inpatients at Vancouver General Hospital. Feedback was solicited through surveys and interviews throughout the process, and helped tailor the dishes to patient preferences. Food waste rates were also measured to complement patient feedback in determining how the new dishes were received.

“We’ve long used the phrase ‘food is medicine’ and we’re finding that this is true not only for patients but for our planet as well,” says Dr. Annie Lalande. “Providing tasty, nutritious meals, which is critical to recovery from illness and injury, also presents a significant opportunity to decrease our environmental footprint by focusing on lower-impact ingredients.”

“Sustainable food and food systems have been a passion of mine throughout my career,” says Chef Ned Bell. “Working to develop menu items that are sustainable and also appeal to a wide variety of tastes on such a massive scale was challenging, but the work we’ve done here has been so rewarding.”

The Planetary Health Menu Pilot has recently concluded. During the coming months, following data analysis, the menu items that patients enjoyed the most will be incorporated into menus across VCH.

This is the first project funded by the Vancouver Coastal Health Boehringer Ingelheim Collaboration (VCH-BI), a partnership announced in 2023 that provides flexible seed funding for innovation initiatives in the areas of planetary health, Indigenous health and chronic disease, and supported by the VGH + UBC Hospital Foundation.

This project was also supported by Greener By Default, who worked in collaboration with the project team on menu consultation, education and evaluation. As participants in Nourish’s second Anchor Cohort during the development of this pilot project, VCH became early adopters of their Planetary Health Menu Program.

Planetary health refers to the interdependent relationship between the health of our communities and the health of the environment, and is an area of increasing concern for health systems. VCH takes a two-pronged approach to planetary health, recognizing the need for both climate change mitigation and adaptation. Learn more about VCH’s commitment to environmental sustainability and accountability as well as other planetary health initiatives at: www.vch.ca/planetaryhealth.

Taking Inspiration from Denmark’s Example in Healthy, Sustainable Food Systems

Since 2004, a collaboration of countries known as the Nordic Cooperation, have been transforming their food system to be healthier for their populations and the environment, bringing to life the vision of the New Nordic Food Manifesto. 

In January 2024, Nourish’s Jen Reynolds and Amy Ford were honoured to be invited to Copenhagen by the World Resources Institute for their Coolfood Summit to learn about how these and other initiatives from around the globe are making an impact on reducing emissions that cause climate change.

We were so inspired to see the transformation 20 years on from the manifesto to now in Denmark and to learn about the journey. Food in public institutions is primarily organic (minimum 60% of ingredients), it celebrates seasonality and place, and it’s a platform for building strong healthy communities - serving, educating and engaging children, elders, hospital patients more in their food and where it comes from. Furthering momentum the Danish Action Plan for Plant-Based Foods released in 2023 charts a path to greater sustainability and health.

In attendance at the Coolfood Summit were leading experts in gastronomy, environmental research, food systems, and more. There is a growing movement of delicious climate action across the world:

• Ikea shared highlights of their many years of work to develop a plant-based alternative to their most iconic food product, meatballs, served around the world, and celebrate its resounding success. This spurred lively discussions about the benefits of meat-imitation vs. featuring plant foods in more natural states. Ikea is seen as a world leader in mainstream climate-friendly menus and was an early Coolfood Pledge signatory.

• The World Resources Institute shared a sneak peek of their updated 2.0 Playbook for Guiding Diners to Plant-Based Dishes in Food Service featuring a host of “no regret” menu updates to inspire food service guests to eagerly choose the most climate-friendly options. The playbook is based on extensive behavioural science showing simple ways to encourage dishes that have a lower climate impact, like serving salads on colourful plates instead of white ones. (see 2020 playbook)

• The MAD Academy shared about its vision for a better tomorrow, stemming from its founding by restaurant noma’s owner Rene Redzepi, as a place to inspire food-based sustainable change. They are training the next generation of chefs, baristas, and bartenders to use elevated gastronomy and impeccable ingredient sourcing to pave the way to reduced emissions in the most delicious way.

The message was clear and Nourish is excited to keep building momentum in Canada: health care providers are uniquely positioned to demonstrate anchor leadership in their communities and industry, by leveraging the power of food for positive change. Simple shifts like serving less-carbon-intensive ingredients, and strategically prioritizing sustainability in procurement practices, translate into putting both patients and the planet at the centre of hospital food service.  This can lead to a thriving system that honours the land we live on, and the health of our communities. 

Watch the webinar on April 4, 2024, to be inspired by the Danish food system innovation!

EOIs Due March 8, 2024

Nourish is excited to offer two research scan contracts (March - June 2024) focused on critical areas within our field - Indigenous foodways and food prescribing. 

If you have a passion for advancing health equity by integrating Indigenous foodways into health care, or if you are intrigued by the transformative potential of food as medicine through food prescribing, we want to hear from you! Both research scans will shed light on the challenges and opportunities present in these areas, supporting Nourish to continue to advance meaningful progress around food for health.

Expressions of Interest for both research contracts can be submitted by March 8, 2024. Please find more details below (and on our website) regarding the scope of research, application process, and timeline.